Centura Health faces class-action suit alleging predatory billing

A man who had a knee replacement at a Centura Health hospital last year has filed a class-action lawsuit against the Centennial, Colo.-based organization for what he claims are predatory billing practices, according to The Durango Herald.

The patient, Franklin Walter, went to Mercy Regional Medical Center in Derango, Colo., for the routine surgery in April 2019, and two months later, he received what he called a "surprise" medical bill for $1,216.73, the newspaper reports. 

Mr. Walter said that he had to sign a "consent for medical treatment" contract requiring him to pay all costs associated with the knee replacement before the procedure. That contract also requires Centura to give patients an estimate of out-of-pocket costs, according to the lawsuit.

But Mr. Walter claims Centura never gave him that out-of-pocket estimate, which led him to believe he didn't owe anything out of pocket for the knee replacement and resulted in the surprise bill.

The lawsuit also claims that Mercy Regional's lists out prices for medical procedures failed to list the price of an arthroplasty, the procedure Mr. Walter had. The chargemaster doesn't list costs of the most frequently used medications, and Centura charged "arbitrary and grossly inflated" ones, Mr. Walter alleged.

"For example, medications are often triple, quadruple, or more than the full retail price, and include costs that exceed amounts a third-party payer will pay for them," the lawsuit alleges. 

The class action case seeks to include all patients from February 2017 until now  who didn't receive an estimate of the amount owed before or the day of the procedure and received surprise bills. 

In the lawsuit, filed in the U.S. District Court for the District of Colorado, Mr. Walter and his lawyers seek compensation for an alleged breach of contract and seek a change in the health system's billing practices.  Mr. Walter also is asking for $5 million in damages, an amount based on the number of people lawyers estimate were affected by Centura's billing practice since February 2017. 

Centura Health declined the Herald's request for comment. The health system is expected to file a response to the class-action in August. 

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